{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T12:30:00Z","timestamp":1791549000065,"version":"4.3.4"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"21","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2006,5,30]]},"abstract":"<jats:p>\n            <jats:bold>\n              <jats:italic>Background\u2014<\/jats:italic>\n            <\/jats:bold>\n            Q waves on a 12-lead ECG are markers of a prior myocardial infarction (MI). However, they may regress or even disappear over time, and there is no specific ECG sign of a non\u2013Q-wave MI. Fragmented QRS complexes (fQRSs), which include various RSR\u2032 patterns, without a typical bundle-branch block are markers of altered ventricular depolarization owing to a prior myocardial scar. We postulated that the presence of an fQRS might improve the ability to detect a prior MI compared with Q waves alone by ECG.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Methods and Results\u2014<\/jats:italic>\n            <\/jats:bold>\n            A cohort of 479 consecutive patients (mean\u00b1SD age, 58.2\u00b113.2 years; 283 males) who were referred for nuclear stress tests was studied. The fQRS included various morphologies of the QRS (&lt;120 ms), which included an additional R wave (R\u2032) or notching in the nadir of the S wave, or &gt;1 R\u2032 (fragmentation) in 2 contiguous leads, corresponding to a major coronary artery territory. The Q wave was present in 71 (14.8%) patients, an fQRS was present in 191 (34.9%) patients, and an fQRS and\/or a Q wave was present in 203 (42.3%) patients. Sensitivity, specificity, and the negative predictive value for myocardial scar as detected by single photon emission computed tomography analysis were 36.3%, 99.2%, and 70.8%, respectively, for the Q wave alone; 85.6%, 89%, and 92.7%, respectively, for the fQRS; and 91.4%, 89%, and 94.2%, respectively, for the Q wave and\/or fQRS.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Conclusions\u2014<\/jats:italic>\n            <\/jats:bold>\n            The fQRS on a 12-lead ECG is a marker of a prior MI, defined by regional perfusion abnormalities, which has a substantially higher sensitivity and negative predictive value compared with the Q wave.\n          <\/jats:p>","DOI":"10.1161\/circulationaha.105.595892","type":"journal-article","created":{"date-parts":[[2006,5,23]],"date-time":"2006-05-23T00:44:29Z","timestamp":1148345069000},"page":"2495-2501","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":527,"title":["Significance of a Fragmented QRS Complex Versus a Q Wave in Patients With Coronary Artery Disease"],"prefix":"10.1161","volume":"113","author":[{"given":"Mithilesh K.","family":"Das","sequence":"first","affiliation":[{"name":"From the Krannert Institute of Cardiology (M.K.D., B.K., S.J., J.M.), Indiana School of Medicine, Indianapolis, Ind, and the College of Arts and Sciences (A.K.), New York University, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bilal","family":"Khan","sequence":"additional","affiliation":[{"name":"From the Krannert Institute of Cardiology (M.K.D., B.K., S.J., J.M.), Indiana School of Medicine, Indianapolis, Ind, and the College of Arts and Sciences (A.K.), New York University, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sony","family":"Jacob","sequence":"additional","affiliation":[{"name":"From the Krannert Institute of Cardiology (M.K.D., B.K., S.J., J.M.), Indiana School of Medicine, Indianapolis, Ind, and the College of Arts and Sciences (A.K.), New York University, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Awaneesh","family":"Kumar","sequence":"additional","affiliation":[{"name":"From the Krannert Institute of Cardiology (M.K.D., B.K., S.J., J.M.), Indiana School of Medicine, Indianapolis, Ind, and the College of Arts and Sciences (A.K.), New York University, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo","family":"Mahenthiran","sequence":"additional","affiliation":[{"name":"From the Krannert Institute of Cardiology (M.K.D., B.K., S.J., J.M.), Indiana School of Medicine, Indianapolis, Ind, and the College of Arts and Sciences (A.K.), New York University, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","unstructured":"Roberts R Pratt CM Alexander RW. Pathophysiology recognition and treatment of acute myocardial infarction and its complications. In: Schlant RC Alexander RW eds. Hurst\u2019s the Heart: Arteries and Veins. New York: McGraw-Hill; 1994: 1107\u20131184."},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1253\/jcj.54.12_1517"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nuclcard.2003.10.009"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2004.03.024"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2003.07.052"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1053\/euhj.2000.2426"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(01)01203-7"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.32.4.440"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.39.4.531"},{"key":"e_1_3_2_10_2","first-page":"1285.","volume":"37","year":"2001","unstructured":"Das MK, Cheriparambill K, Makan M, Saul B, Kassotis J, Reddy CVR. RSR\u2032 pattern without bundle branch block: diagnostic value as a sign of left ventricular aneurysm. J Am Coll Cardiol. 2001; 37: 1285. Abstract.","journal-title":"J Am Coll Cardiol"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1542-474X.2006.00094.x"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(91)90138-8"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(88)91056-9"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.105.4.539"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s002590100618"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.2307\/2531595"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(92)90648-F"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.40.6.927"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/0022-0736(88)90061-1"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02584541"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(73)90039-2"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.72.3.4017211"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1161\/res.36.1.1116215"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(84)90138-8"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1253\/jcj.63.25"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCULATIONAHA.105.595892","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T05:21:08Z","timestamp":1715577668000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCULATIONAHA.105.595892"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,5,30]]},"references-count":25,"journal-issue":{"issue":"21","published-print":{"date-parts":[[2006,5,30]]}},"alternative-id":["10.1161\/CIRCULATIONAHA.105.595892"],"URL":"https:\/\/doi.org\/10.1161\/circulationaha.105.595892","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,5,30]]},"assertion":[{"value":"2006-05-22","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}